马兜铃酸毒性控制研究进展

Plants from the Aristolochiaceae family,such as those from the genus Aristolochia spp.and Asarum spp.,are important sources of traditional Chinese medicine.The active components they contain,such as terpenoids and alkaloids,have been proven to have pharmacological activities including anti-tumor effects,immune regulation,and broad-spectrum antibacterial properties.However,these plants also contain nitrophenanthrene carboxylic acid compounds-aristolochic acids(AAs).After metabolic activation,AAs can form DNA adducts,induce characteristic mutations in the TP53 gene,and cause necrosis of renal tubular epithelial cells,leading to aristolochic acid nephropathy(AAN)and upper urinary tract urothelial carcinoma(UTUC).The International Agency for Research on Cancer(IARC)has classified them as Group 1 human carcinogens. Current research is focused on establishing a technical system for the separation of"efficacious and toxic components."Through strategies such as targeted extraction,biotransformation,and structural modification,it aims to precisely remove AA components while retaining the active medicinal fractions.This is of great significance for promoting the safe clinical application of medicinal materials from the Aristolochiaceae family. This article reviews the toxicity mechanisms,detection technologies,and detoxification methods while retaining efficacy of aristolochic acids.Under the context of transitioning from"traditional empirical medication"to"evidence-based and precise medication,"it summarizes modern pharmacotoxicological theories and separation engineering technologies.This review aims to contribute to the paradigm innovation of"identifiable,controllable,and transformable"toxic components in traditional Chinese medicine,and to assist in the construction of a technical system for the safety research of traditional Chinese medicine.